FORM 1023-EZ for FUSION VOLLEYBALL CLUB

Field Data
EIN 47-4970977
Case Number EO-2015295-000386
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FUSION VOLLEYBALL CLUB
Organization’s Mailing Address 6165 THACKER DIARY ROAD
City WHITSETT
State NC
ZIP 27377
Accounting period End 8
Primary contact name LORI KENNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LISA ANDREWS
CLUB DIRECTOR/PRESIDENT
6165 THACKER DAIRY ROAD
WHITSETT NC 27377

Officer/Director/Trustee Two

MICHAEL JOHNSON
VICE-PRESIDENT
2530 BELLEMONT ALAMANCE ROAD
BURLINGTON NC 27215-9614

Officer/Director/Trustee Three

LORI KENNEY
TREASURER
5901 WILLOW OAK DRIVE
MEBANE NC 27302

Officer/Director/Trustee Four

KIM RAY
SECRETARY
1848 BILLY T TRAIL
MEBANE NC 27302

Organization’s website HTTP://WWW.FUSIONVOLLEYBALLCLUB.TEAMPAGES.COM/
Organization’s email PLKENNEY@TRIAD.RR.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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